Spencer Mark, Hall Matthew, Schafer Allison, Geaney Lauren E
University of Connecticut Health Center Farmington Connecticut USA.
UCONN Orthopedic Surgery, Resident Farmington Connecticut USA.
Australas J Ultrasound Med. 2023 Jan 17;26(3):169-174. doi: 10.1002/ajum.12330. eCollection 2023 Aug.
The purpose of this study was to assess the safety of ultrasound-guided corticosteroid injections into the posterior tibial tendon sheath for posterior tibialis tendinopathy. Secondary outcomes include duration of pain relief, amount of pain relief, need for repeat injections and progression to surgery.
We retrospectively reviewed all patients in our electronic medical record who underwent a posterior tibial tendon sheath (PTTS) steroid injection between 2015 and 2020 for the diagnosis of posterior tibial tendon dysfunction and/or posterior tibialis tendon insufficiency, and/or ankle pain. Demographic information was obtained from the patient record in addition to MRI data, clinical response to injection based on follow-up visits, number of total injections and progression to surgery. Thirty-eight posterior tibial tendon sheath ultrasound-guided injections were administered in 33 patients who met inclusion criteria during the 5-year study period.
Thirty-three patients were included in the study with a total of 38 injections performed. Eighteen of 38 (47%) injections yielded good or better pain relief. Seven of 33 patients (21%) progressed to surgery. There were no reported complications with the 38 performed injections.
Ultrasound-guided corticosteroid injection into the posterior tibial tendon sheath is a safe nonoperative treatment modality for progressive collapsing foot deformity. The efficacy of the injection appears highly variable with 47% of injections yielding 'good' or better clinical results. When evaluating body mass index (BMI), obese patients (BMI ≥30.0) were found to have a more sustained response to injection (P = 0.029) and more pain relief (P = 0.049) than non-obese patients.
本研究旨在评估超声引导下将皮质类固醇注射到胫后肌腱鞘治疗胫后肌腱病的安全性。次要结果包括疼痛缓解的持续时间、疼痛缓解的程度、重复注射的必要性以及是否进展为手术治疗。
我们回顾性分析了2015年至2020年间在我们电子病历中因诊断为胫后肌腱功能障碍和/或胫后肌腱功能不全和/或踝关节疼痛而接受胫后肌腱鞘（PTTS）类固醇注射的所有患者。除了MRI数据外，还从患者记录中获取了人口统计学信息、基于随访的注射临床反应、总注射次数以及是否进展为手术治疗。在5年的研究期间，对33名符合纳入标准的患者进行了38次超声引导下的胫后肌腱鞘注射。
33名患者纳入研究，共进行了38次注射。38次注射中有18次（47%）产生了良好或更好的疼痛缓解效果。33名患者中有7名（21%）进展为手术治疗。38次注射均未报告并发症。
超声引导下将皮质类固醇注射到胫后肌腱鞘是治疗进行性扁平足畸形的一种安全的非手术治疗方式。注射的疗效差异很大，47%的注射产生了“良好”或更好的临床效果。在评估体重指数（BMI）时，发现肥胖患者（BMI≥30.0）比非肥胖患者对注射有更持久的反应（P = 0.029）和更多的疼痛缓解（P = 0.049）。
